- Report: #1323098
Complaint Review: AFLAC NJ - COLUMBUS Georgia
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AFLAC NJ
1932 Wynnton Road COLUMBUS, 31999 Georgia, USA
Phone:
800.992.3522
Web:
WWW.AFLAC.COM
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AFLAC NJ AFLAC REFUSES TO PAY CLAIMS COLUMBUS Georgia
On February 16, 2016 I had cervical surgery at a Hospital in New Jersey. After my surgery I was scheduled to stay in the hospital for 24-48 hours however I was in a great deal of pain and the medical staff felt it best that I was not discharged until the pain was under control. On February 19, 2016 at 12:29 am the nursing staff administered, as instructed, 10 mg of morphine for pain. Around 5 AM the nursing staff stated that they were unable to wake me and called in the Rapid Response team. The Rapid response team oversaw the situation until about 7:30 am when I was deemed stable. All of the above information is documented and has been received by AFLAC.
Two hours later about 9:30 am, they nursing staff stated that they were unable to wake me again at which point they called in the Director of pain management. Due to the amount of time that had gone by without improvement, and that they were unable to wake me, the pain management nurse dispenses a dose of Narcan to reverse the effects of the morphine. This was not/is not malpractice nor was it an allergic reaction. It was simply an accident that occurred. I was released from the hospital the next day Saturday February 20, 2016.
As a result of this situation, I suffered from chest pains, heart palpitations, and shortness of breath, lightheadedness, dizzy spells, and fainting for months thereafter. I was treated by my general doctor, a cardiologist and even hospitalized again on May 31, 2016 to June 1, 2106 for Acute Coronary Syndrome directly related to the February 19, 2016 accident.
My claim submission to Aflac for the accident that occurred on February 19, 2016 has been denied and as a result of that denial, all other claims relating to that accident have been denied as well. The incident that occurred on February 19, 2016 was an accident. However AFLAC denied it the first time saying because it was a overdose it is malpractice and they will not pay it. I have contacted an attorney and it is not malpractice. Then AFLAC denied it a second time saying it was an allergic reaction and they would not pay it. It was not an allergic reaction.
I have emailed my agent a dozen or more times and received no assistance even no response at times. I lost my job in Feb 2015 and have been paying for Cancer, Accident and STD policy out of my own pocket since. They have also refused to pay my STD policy which was initially started/paid August 4, 2015 but I am still out on disability. They said its not payable because I did not return to work for 14 days. I explained that I do not have a job to return to so that would have been impossible.
I have been in the insurance industry for over 20 years, I have never experienced anything like this before; between the rude CSA, the denial of claims, the changes in the reason for denial, the complete disregard my agent has exhibited and the inability to get a knowledgeable person on the phone (they wont put me throught to a manager or supervisor). I am beyond fustrated and have decided the only way to resolve these issues is through legal action.
Very fustrated and disappointed!
